快速眼动期睡眠行为障碍与帕金森病的关联及其早期生物学标志物的研究  

Potential markers of Parkinson＇s disease in rapid eye movement sleep behavior disorder

作　　者：张淋源[1] 杨琼[1] 康文岩[1] 陈伟[1] 陈生弟[1] 刘军[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院神经内科上海交通大学医学院神经病学研究所,200025

出　　处：《临床内科杂志》2014年第12期811-813,共3页Journal of Clinical Internal Medicine

基　　金：国家自然科学基金（面上项目）资助项目（81071024、81171202、30872729、30870879、81129018）;上海市“曙光计划”（11SG20）

摘　　要：目的 探讨帕金森病（PD）潜在的早期生物学标志物在快速眼动期睡眠行为障碍（RBD）患者与PD患者之间的关联与差异.方法 采用统一帕金森病评定量表（UPDRS）、简易智能精神状态检查量表（MMSE）、汉密尔顿抑郁量表（HAMD-17）、帕金森病自主神经功能量表（SCOPA-AUT）、RBD筛查问卷（RBDSQ）对10例特发性RBD患者、15例PD伴RBD患者、15例PD不伴RBD患者和10例健康对照者进行运动症状及非运动症状的评定,并将上述指标在4组间进行组间比较及相关分析.结果 SCOPA-AUT评定结果显示,特发性RBD患者的非运动症状评分介于正常对照与PD患者之间（P＜0.05）,且所有被试者SCOPA-AUT评分与RBDSQ评分呈显著正相关（R=0.561,P＜0.05）.HAMD-17、MMSE评分在4组间比较差异无统计学意义（P＞0.05）,且与RBDSQ评分相关性无统计学意义（P＞0.05）.结论 RBD与PD密切相关,特发性RBD患者自主神经功能症状的严重程度介于正常对照与PD患者之间,提示自主神经功能症状有可能成为预测RBD患者发展成为PD风险的潜在生物学标记物.Objective To investigate potential biomarkers of Parkinson＇ s disease（PD） in rapid eye movement sleep behavior disorders（RBD） to evaluate the usefulness of these biomarkers in identifying individuals with idiopathic RBD which are at risk of developing PD. Methods We employed the Unified Parkinson＇ s Disease Rating Scale （UPDRS） and Hoehn-Yahr stage （H-Y stage） scores to assess motor symptoms, together with the Mini-Mental State Examination （MMSE）, Hamilton Depression Rating Scale-17 （ HAMD-17）, the Scales for Outcomes in Parkinson＇ s disease-Autonomic （ SCOPA-AUT）, rapid eye movement behavior disorder screening questionnaire （RBDSQ） evaluating the non-motor manifesta- tions in 10 idiopathic RBD patients, 15 PD patients with RBD, 15 patients without RBD and 10 normal controls. We compared the difference in these biomarkers between the four groups and also performed the correlation analysis between them. Results SCOPA-AUT scores of idiopathic RBD patients were between PD patients and normal control （ P 〈 0. 05 ）. Moreover, there was a significantly correlation between SCOPA-AUT scores and RBDSQ scores （R = 0. 561, P 〈 0.05 ）. There were no significant differences in HAMD-17 scores and MMSE scores among the four groups（P 〉 0.05） and the scores of these two scales were not significantly related to RBDSQ （ P 〉 0.05 ）. Conclusion RBD is closely linked with PD. The se- verity of autonomic symptoms in idiopathic RBD patients is intermediate between normal controls and PD patients, and closely correlate with RBD status, suggesting autonomic dysfunction assessed by SCOPA-AUT may predict individuals with idiopathic RBD who are at risk of PD.

关 键 词：帕金森病 快速眼动期睡眠行为障碍 自主神经功能症状 

分 类 号：R749.71[医药卫生—神经病学与精神病学]